Pertussis in young infants: apnoea and intra-familial infection

This study investigated 41 infants, aged <4 months, who were hospitalised with symptoms compatible with pertussis. Of these, 16 had Bordetella pertussis infection confirmed by real-time PCR. For four of these 16 patients, the initial sample was PCR-negative, but samples collected 5-7 days after the onset of infection were PCR-positive. PCR was also positive with samples from 15/16 families and 20/41 household contacts. Nine of the 20 positive household contacts were asymptomatic. Among the 16 infants with proven pertussis, apnoea was more frequent than in a control group for whom PCR was negative with both children and household contacts (69% vs. 28%). It was concluded that real-time PCR performed with samples from household contacts facilitates the diagnosis of infants suspected clinically of having pertussis, thereby enabling earlier treatment.     

安乐死离我们还遥远临终关怀离我们却很近

我国自20世纪80年代就开始了对安乐死立法的讨论，有的人赞同安乐死，有的人反对安乐死。就我国现阶段的社会状况来说，尚不具备为安乐死立法的社会条件。而对于那些身患绝症、救治无望、极度痛苦的濒临死亡而又惧怕死亡的病人，如何解决他们生理的、心理的、生活的痛苦、焦虑与不安？临终关怀是最好的选择。     

Immunolocalization of fibronectin and vitronectin receptors in human gingival fibroblasts spreading on titanium surfaces

The adhesion and spreading of human gingival fibroblasls on glass and differently processed titanium surfaces was studied by immunolocalization of vinculin and the alpha and beta subunits of the fibronectin (α₅β₁) and vitronectin (α_vβ3) receptors. Vinculin-containing focal contacts were present both at 4 and 24 h of spreading in cells grown on glass or electropolished or etched titanium surfaces but not in cells spreading on sandblasted titanium surfaces. Immunostaining for the α5 and β1 subunits of the fibronectin receptor showed only a diffuse membrane fluorescence after 4 h of cell spreading irrespective of the growth surface. The α_v and β₃ subunits of the vitronectin receptor were at this stage detected in focal contacts in cells spreading on glass or electropolished or etched titanium surfaces. In cells spreading on sandblasted titanium surfaces, however, the vitronectin receptor had only a diffuse distribution. In cells that had been allowed to spread for 24 h on glass or electropolished or etched titanium surfaces the α₅ and β₁ integrin subunits were either diffusely distributed or showed a localization typical of extracellular matrix contacts. The α_v and β₃ integrin subunits were, as earlier, localized to typical focal contacts in cells grown on glass or electropolished or etched titanium surfaces. Cells attached to sandblasted titanium surfaces still expressed all the integrin subunits only diffusely. The results show that the surface texture of the substratum can affect the expression of integrin subunits in human gingival fibroblasts. As evidenced by the recruitment of integrin subunits to focal and extracellular matrix contacts, smooth or finely grooved titanium surfaces appear to be optimal in supporting the attachment of human gingival fibroblasts.     

Spinal epidural hematomas

During the period 1943–1985 six patients were operated for spinal epidural hematomas at the department of neurosurgery of the University Hospital of Århus. It is essential to perform acute laminectomy in case of rapidly increasing neurological symptoms. In the case of slowly increasing symptoms operation may provide a good result even if it is performed a week after the onset of symptoms. It is important to watch patients with fracture/dislocations of the spine closely during the first weeks after a trauma. If they develop neurological symptoms the patients should immediately be transferred to the department of neurosurgery with a view of acute diagnosis and possibly acute surgery.     

合肥市2004年流行性脑脊髓膜炎疫情分析

目的了解合肥市2004年流行性脑脊髓膜炎(流脑)高发的原因,为制订预防控制策略提供依据。方法对流脑病例的流行病学、临床、实验室检测资料进行描述流行病学分析。结果合肥市2004年共发生流脑69例,发病率为1.50/10万,较前5年平均发病率上升了10倍。经实验室和流行病学诊断的病例C群占20.29%,A群占18.84%,其余为临床诊断的未分型病例。对1 171名密切接触者咽拭子采样检测平均带菌率为8.28%;其中以初中生和高中生带菌率为高,分别为14.07%和14.76%。所带菌群以C群最高,平均为4.27%;死亡病例和爆发病例的密切接触者中,C群带菌率分别为30.1%和14.7%。结论做好流脑的临床诊治和预防控制,必须开展流脑的病原学检测,并对密切接触者进行带菌检测,有针对性的采取预防控制措施。     

Ultrastructural studies of physiologically identified electrosensory afferent synapses in the gymnotiform fish, Eigenmannia

Eigenmannia is a weakly electric fish that emits a constant-frequency electric organ discharge (EOD). Probability coder (P unit) and phase coder (T unit) electroreceptive afferents differentially encode changes in EOD amplitude and phase, respectively. physiologically identified T and P units were intracellularly labelled with HRP and their terminals were examined with electron microscopy to determine their postsynaptic targets. This technique reveals that phase and amplitude are relayed to first-order electrosensory neurons by two parallel but not independent pathways. P-type afferents terminate on granular interneurons, basilar pyramidals, and polymorphic cells, electrosensory lateral line lobe targets that monitor amplitude modulations, but P-type afferents do not contact spherical cells. T-type afferents relay phase information to spherical cells and thus form a separate afferent pathway. T unit terminals do not synapse directly on basilar pyramidal cells. Collateral branches from T-type afferents, however, were also found to terminate on granule and polymorphic cells, thereby adding phase information into the amplitude channel. P- and T-type afferents exhibit cellular specificity by forming synaptic junctions with different subsets of post synaptic targets in the deep neuropil. The afferent terminals make either asymmetric chemical or gap junction synapses depending on the identity of the post synaptic target. T units contacting granule cells or polymorphic cells had not been previously described. Two possible roles of adding phase to amplitude information are discussed in terms of electrolocation.     

Effect of Mouthpiece Washing on Aerosol Performance of CFC-Free Ventolin™

The prescribing information for chlorofluorocarbon (CFC)-free salbutamol metered-dose inhalers carries a strongly-worded instruction to wash the mouthpiece weekly, but patients rarely carry this out. This study investigated the effect of washing/not washing the mouthpiece on CFC-free Ventolin™ aerosol performance. Twelve CFC-free Ventolin™ inhalers were actuated two puffs four times/day, and assessed by unit dose sampler and cascade impactor on Days 1, 7, 8, 14, 15, 21, and 22 (“through-life,” i.e., over the entire content of the inhaler). The mouthpieces of six inhalers were washed after the last actuation on Days 7, 14, and 21. A single priming maneuver, as recommended by the manufacturer, was sufficient for fine particle mass. There were no significant through-life differences in delivered dose between washed and unwashed inhalers. Without washing, fine particle mass fell from 47 µg to 33 µg (Friedman p = 0.002). Fine particle mass increased significantly after washing (median change + 11.2 µg, p = 0.019 cf. unwashed). Large particle mass showed no significant through-life trend for washed or unwashed inhalers, but was significantly reduced after washing (p = 0.04 cf. unwashed). This study shows a progressive through-life reduction in fine particle mass from CFC-free Ventolin™ inhalers, which is prevented by weekly mouthpiece washing. However, in view of the steep bronchodilator dose-response curve for salbutamol, further studies are needed to determine whether such device care is clinically necessary.     

Glutamate-positive neurons and axon terminals in cat sensory cortex: a correlative light and electron microscopic study

Immunocytochemical methods were used to perform a correlative light and electron microscopic study of neurons and axon terminals immunoreactive to the antiglutamate (Glu) serum of Hepler et al. ('88) in the visual and somatic sensory areas of cats. At the light microscopic level, numerous Glu-positive neurons were found in all layers except layer I of both cortical areas. On the basis of the dendritic staining of Glu-positive cells, two major morphological categories were found: pyramidal cells, which were the most frequent type of immunostained neuron, and multipolar neurons, which were more numerous in layer IV of area 17 than in any other layer. A large number of Glu-positive neurons, however, did not display dendritic labelling and were considered unidentified neurons. Counts of labelled neurons were performed in the striate cortex; approximately 40% were Glu-positive. Numerous lightly stained punctate structures were observed in all cortical layers: the majority of these Glu-positive puncta were in the neuropil. After resectioning the plastic sections for electron microscopy it was observed that: 1) the majority of neurons unidentifiable at light microscopic level were indeed pyramidal neurons except in layer IV of area 17, where many stained cells were probably spiny stellate neurons. Some Glu-positive neurons, however, exhibited clear ultrastructural features of nonspiny nonpyramidal cells; 2) all synaptic contacts made by Glu-positive axon terminals were of the asymmetric type, but not all asymmetric synaptic contacts were labelled. The vast majority of postsynaptic targets of Glu-positive axons were unlabelled dendritic spines and shafts. The present results provide further evidence that Glu (or a closely related compound) is probably the neurotransmitter of numerous excitatory neurons in the neocortex.